'People are hungry to know information about their health so they can help themselves'

Ana Cazares is a volunteer community health worker who's so determined to broach taboo health subjects in her Pilsen neighborhood that she uses every opportunity that presents itself.

Cazares was recently shopping in a local store when the Latina owner sheepishly confided in Cazares that she couldn't control her bladder.

Despite an increased awareness of incontinence these days, especially from television advertisements, the topic remains a difficult one for many women to take up. Cazares said it's a particularly difficult subject among Hispanic women, who tend to be shy about discussing "below the belt" issues, even with their physicians.

Perhaps that's why as Cazares helped the first woman in the store that day, seven others hovered nearby, pretending to examine items on the shelves — while eavesdropping.

"They all had the same problem," said Cazares. "No one wanted to say anything because they're too ashamed to talk about it. But I'm not ashamed. I said, 'Do you want me to show you what can help?'"

Cazares, 58, led the women to a back corner of the grocery store. She then lay down on a piece of cardboard and started to explain how to do exercises, called Kegels, designed to strengthen muscles along the pelvic floor.

The women watched in rapt attention.

According to the Chicago-based Women's Health Foundation, 1 in 3 American women will suffer from a pelvic health disorder in her lifetime. Disorders include urinary incontinence, pelvic pain, fibroids, a prolapsed uterus and heavy menstrual periods.

A Loyola University Chicago Stritch School of Medicine study, published in 2011, found that about 28.1 million women are affected by incontinence alone.

"Many of these women are willing to just live with it," said Cazares. "They may have problems being intimate with their husbands. Sometimes they are dealing with odor and they're embarrassed and they think it's their fault."

For many women, Kegel exercises solve incontinence problems without expensive surgeries. Cazares said this is particularly important for women who can't afford health insurance and might ignore ailments, fearing they might be too costly to address.

Cazares has been volunteering at the Alivio Medical Center in Pilsen for about five years. One aspect of the center's mission is to promote early detection and prevention of diseases in its patients, who are low-income Latinos.

The center sends volunteers out into the community, to schools and other clinics, to teach residents such things as the importance of making healthy lifestyle changes and being vigilant about screenings for breast cancer and diabetes.

Cazares and other Alivio volunteers received training on pelvic health last summer during a course given by the Women's Health Foundation. Volunteers learned that the more babies a woman has, the more inclined she may be to have pelvic problems. As a woman ages, she also may be more susceptible. And the same is true for an athlete whose sport stresses her pelvic floor.

(It's also important to note that alcohol, chocolate, spicy foods, highly acidic foods and even broccoli can cause irritation in the pelvic region.)

"We don't talk about these types of problems," said Cazares. "I even tell women that when they're looking for pads or undergarments in stores, they might not find these products in the feminine hygiene aisle.

"In some stores, they may be near the pharmacy or in an aisle with health care-related items. But (women) shouldn't be embarrassed about asking."

Cazares, who was born in Mexico and came to Chicago 25 years ago, said that while women may speak freely about their families and caring for children, they rarely mention reproductive health.

"My mother never talked about it to me," she said. "In Mexico, whenever there were meetings about health, I went because I liked to be informed. If I could, I would have studied to be a doctor."

Cazares is a vegetarian who exercises regularly. She has a husband and three sons, and she tries to teach them to be aware of what's going on inside their bodies. Men who have had prostate problems also may face incontinence.

She said she recently followed up with the store owner to see how she was doing.

"She said she was feeling good, and I couldn't imagine how her life had changed in the short time she'd been doing the exercises," said Cazares.

"People are hungry to know information about their health so they can help themselves. It helps them feel better (physically), but it gives them confidence and makes them feel in charge."